Practice Management in the21st CenturyHealthcareTeetering on the Edge?Mark StallwoodDip Practice Management, B.V.Sc, Grad Dip Ed. MBA.
Macro ViewWHO defines healthcare system as theorganization of people, institutions, andresources to deliver health care services tomeet the health needs of targetpopulations.
Entitlements• The right to a system of health protectionproviding equality of opportunity foreveryone to enjoy the highest attainablelevel of health;• The right to prevention, treatment andcontrol of diseases;• Access to essential medicines;
SO...• Different countries approach healthcarein different ways and this determineshow we manage practice…
• Government (Federal &State)managed• Includes Medicare, PBS, PublicHealth• GP’s are gatekeepers• Taxpayer funded universalsystem (levy), medical (pays 85%of costs) and somepharmaceutical & dental• Private system is ancillary,insurance (52%) & provision ofservices.
• Government managed• Includes medical, prescriptions,some dental• Taxpayer funded universalsystem• GP’s are gatekeepers• GP co payment $30• Private system is ancillary,insurance (32%) & provision ofservices.
• Government managed(Provinces and Territories)• Includes medical, hospital, inpatient prescriptions,• Taxpayer funded• GP co payment $30• Private system is ancillary,insurance (66%) for additionalservices.
• Government managed• Taxpayer funded universalsystem• GP’s are gatekeepers• Prescription co payment $15• Private system is ancillary,insurance (11%) & provision ofelective services.
• Fragmented management• Mix of Private and NFP• Private cover (56% -50%underinsured)▫ 500 companies• Govt. Public (27%)• No Cover (16%)• GP’s not gatekeepers
“In a perfect world, you would see apatient, submit a claim, and get paid. In aperfect world, what you charged for theprocedure or service would reasonablyreflect both the cost and the value of whatyou did, and you would, in fact, be paidwhat you charged” (Cohen 2011 Medical Economics)
What is Practice Management• focus on the best use of resources toachieve the best outcomes for patients,in the most cost effective and efficientmanner and provide an acceptablereturn to all involved in providing thatservice.
What many people think• Focus on billing patients• Ensure patients bookings are happening• Basic administration
What it actually is…• Human Resource Management• Financial Management• Risk and Compliance Management• Marketing• Logistics• Planning
Practice is a businessSome interesting facts….• 75% have no plan• 80% have no budget• Medical practices go bankrupt• Accreditation is not best practice it isminimum standards
What else has changed• Patients in many countries now havechoice – Healthcare consumersIssues are now:▫ Time▫ Convenience▫ Outcomes▫ Perceived level of Service
Financial Management• No budget• No cash flow management• No asset management• Few audit processes
Risk Management & Compliance• Poor understanding of business risk• 120+ pieces of non medical legislation• OWH & S• IR
MarketingApplies to all practicesAll about communication to:• Patient• Colleagues• Potential Staff
Marketing (2)• Practice Image• Logo, Letterheads• Newsletters• Web Page• Social Media
ICTKeeping up to date• Practice management systems• Webpages• Social Media• Communication Systems• Online Booking systems
Planning• No shared values• No shared direction• No goals• No succession plan
So where is the evidence?Department of Education, Employment andWorkplace Relations funded a study by theSociety for Knowledge Economics Leadership in2011Culture and Management Practices of HighPerforming Workplaces in Australia• Only service industries• 5600 employees
Findings1. People management is a key priority2. Involvement of staff in decision makingprocess occurs3. These organisations are more responsiveto customers and key stakeholders4. They have a learning culture5. They enable staff to fully utilise their skillsand abilities
Findings – Startling Bits!• High performing workplacesgenerate 12% more revenue than similarbusinesses that were low performing.• The profit margin in High PerformingWorkplaces (HPW) is nearly three timesgreater than in Low PerformingWorkplaces (LPW).